Critical Illness Polyneuropathy, Critical Illness Myopathy, and ICU-Acquired Weakness

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🌱 來自: Huppert’s Notes

Critical Illness Polyneuropathy, Critical Illness Myopathy, and ICU-Acquired Weakness🚧 施工中

Critical Illness Polyneuropathy, Critical Illness Myopathy, and ICU-Acquired Weakness

•   Risk factors: Mechanical ventilation, sepsis, prolonged use of paralytics, multiorgan failure, ARDS

•   Clinical manifestations: Symmetric limb weakness (proximal > distal), respiratory muscle weakness leading to failure to wean ventilation, sparing of facial muscles

-   Critical illness polyneuropathy (CIP): Features as noted above

-   Critical illness myopathy (CIM): Features as noted above; sensory loss may be particularly suggestive, CK may be elevated

-   ICU-acquired weakness: Diagnosis of exclusion, first sign is often the failure to wean from mechanical ventilation, spares cranial nerves

•   Management: Minimize sedation and neuromuscular blockade, treat underlying causes, rehabilitation with early mobilization and physical therapy